		
		<tr align="center">
			
				<% i = 3 %>
			<td>	
				  <%= text_field_tag "fields[#{i}][name]",'', :class=>"validate[required] text-input" %>
		    </td>	
			<td>	  
				  <%= select_tag "fields[#{i}][is_question_order]", options_for_select(@h_order.to_a) %>
		    </td>
			<td>
				<%= select_tag "fields[#{i}][is_answer_order]", options_for_select(@h_order.to_a) %>
			</td>
		</tr>
<% i=1+1 %>